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HomeMy WebLinkAbout040-1084-80-150 I' < STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER~~~' S C ADDRESS 2 • p MtYt w 1 a Z P, SUBDIVISION / CSM# CS M 11d L g CS 114 L-LOT # SECTION T N-R W, Town of ag t~j aA50 ST. CROIX COUNTY, WISC1 1ftSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM w6 Y~rt 11 tl~ RECE, EO cur) 5 - 1 1y~3 U-j is~) Go 01 is , w t'Ot~ 7 Y a j j t ~1 IWO) 54- t qd 0 INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. y'~ IP Lit Provide 2 dimensions to center of septic tank manhole cover. ~z 1 e BENCHMARK: S~I/(Lr- ~D A90 v6- 61eZo ct/,O IV 45 0I4, 7&6-6: C7 ALTERNATE BM: z P D + cogly~f= SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: Liquid Capacity: l C ~D Setback from: Well House Other Pump: Manufacturer Model# 6L)(4V--5Size c~ Float seperation Gallons/cycle: Alarm Location SOIL ABSORPTION SYSTEM / Width: Length Number of trenches / Distance & Direction to nearest prop. line: 7 Z O r Setback from: well: House 5S~ /Other ELEVATIONS ~ I Building Sewer ST Inlet: ST outlet PC inlet PC bottom Pump Off Header/Manifold / l~ Ob Bottom of system Existing Grade Final grade i t DATE OF INSTALLATION: PLUMBER ON JOB: j LICENSE NUMBER: INSPECTOR: 3/93:jt N LOCATION: TOWN OF TROY 21.28.19.334A50 SW Lot 4 To Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM ounty: Labor and Human Relations INSPECTION REPORT Safety and Buildings Division (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION Permit Holder's Name: ❑ City ❑ Village [Town of: State Plan ID No.: LAPERRY, JAMES Troy ~ CST BM Elev.: Insp. BM Elev.: BM Description: Pa cel Tax No.: TANK INFORMATION ELEVATION DATA A9300121 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ,gyp f ~L - t,. Benchmark p 6,6 1D0 Dosing fit . t, 97a) p(, 91. Aeration Bldg. Sewer Holding St/Ht Inlet 0 '7 D. a TANK SETBACK INFORMATION St/ Ht Outlet Ventto TANK TO P/ L WELL BLDG. Ai Intake ROAD Dt Inlet X)w Septic NA Dt Bottom Septic V Dosing 31e > NA Header/ Man. J , S Aeration NA Dist. Pipe Holding Bot. System 4ov PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand ~7, 03 lgGPM -7 r, q-7 Model Number ir vx~ //1-137 TDH Lift ~%1 Friction `2 ~ System, ~L) TDH I,,bgFt Forcemain Length/00 I Dia.a/1 Dist. Toweu SOIL ABSORPTION SYSTEM BED/TRENCH Width , Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS / DIMENSIONS SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK CHAMBER INFORMATION Type O / Moe Number: System: h z~scv~ 23 >l00 A f 1~ OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length JO' Dia. ~ I i SpacingT ~IYq 11 I 7 S O SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of TSeeded / Seeded' xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ No Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: TOWN OF TROY 21.28.19.334A50, SW SE, Lc* 4 TownsValley Road 40 R `'1a'ni rtiisrnY~gErire? ❑ Yes No Use other side for additional information. SBD-6710 (R 05/91) --ral ate Inspector's Signature Cert. N H l ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: r t i y e D~LHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COUNTY 01 STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than ❑ 3q 6 8% x 11 inches in size. C if revision to previous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUM ER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION .a!ffmes LA to /Z a ,S Z T ,N,R E(o PROPERTY OWNER' MAILING ADDRESS LOT # BLOCK # CITY, STATE ZIPCODE PHONE NUM ER SUBDIVISI NNAME ORCSM NUMB LS 61 r Paz- -p6 / II. TYPE OF BUILDING: (Check one) CITY NEAREST ROAD I~1 ❑ State Owned VILLAGE : wN.s. ~ L I% =N Q~:z e ❑ Public Yk-or 2 Fam. Dwelling-# of bedrooms PARCEL TAX NUMBER(U) Ill. BUILDING USE: (If building type is public, check all that apply) D J~ f O 8 1 ❑ Apt/Condo V U 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/School 80 Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. R.New 2. ❑ Replacement 3. ❑ Replacement of 4.E] Reconnection of 511 Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit - Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 M Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. T FINAL GRADE (0 C 5-a-D 5-051 1 3 /3~, REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ~l ELEVATION VFeet Feet TO 4 VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New Existing Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank 2cro dTJ cf Lift Pump Tank/Si hon Chamber GO 1 VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumb is Name (Print): Plumber's Sign ure: (No Stamps) 7P/MPRM No.: Business Phone Number: tcrSad Plu 's Address (Street, City, State, Zip Code): IX. COUNTY/DEPARTMENT USE ONLY Date issued Issu'ng Agent Sig lure (No Stamps) Disapproved Sanii ry Permit Fee (Includes Surcharge Fee) Groundwater 14 ~ ~ rl~ ` A Approved ❑ Owner Given Initial ~a Adverse Determination ~ ~~2 X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R.11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the times of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to This permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Saritary Permit Transfer/Renewal Form (S''D 6399) to be submitted to the county priar to installation. 5. Onsite sewage systems matt be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 19 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in ##1-7. VII. Tank information. Fill in the capacity of every new send/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic,, purnp/siphon and holding tanks for this system. Check experimental approval only it tanks received experimental product approval from DILHR. Vlll. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8% x 11 inches must be subm tied '.o tie county. The plans must include the following: A) plot plan, drawn to scale or with complete dirneris;'ons location of holding tank(s), septic tank(s) or other treatment tanks; buii_tir:g sewers; wells; water main~,lwater service; strearns and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontai and vertical elevation referenca poirt:s; C) complete specifications for pumps and controls; dose VOIUrne; elevation differences; fric-ion loss; pump performance curve; pump model and pump manufacturer, D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 isc)n sin Act 419 included the creation of surcharges (fees) for a numb:-,r of regulated practices, which can effect groundwate=r. The rnoniu ct;. i cl through these: surcharge;, are used for monitoring groundwater, ~roun:j- water con'amination investigations and establishment of standards. SBD-6398 (R.11/88) ` SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations PRIVATE SEWAGE PLAN APPROVAL Western Regional Office 2226 Rose Street. LaCrosse, Wisconsin 54603 it WEGERER SOIL TESTING & DESIGN PO BOX 74 RIVER. FALLS WI 54022 RE: Plan Number: S93-40440 Date Approved: June 7, 1993 Gallons Per Day: 600 Date Received: May 26, 1993 Project. Name! LA PER.R.E, JAMES Location: SW,SE,21,28,19W Town of TROY County: ST CROIX The plumbing plans and specifications for this project have been reviewed for compliance with applicable code requirements. This approval is based on Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code. The plans are stamped 'conditionally approved'. This approval is contingent, upon compliance with any stipulations shown on the plans. All items that are noted must be corrected. All permits required by the city, village, township or county shall be obtained prior to construction. The licensed plumber responsible for this installation shall keep one set of plans with the department's approval stamp at the construction site. The installer shall notify the appropriate inspector when inspections can be made. This approval will expire two years from the date approved or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires. The Section of Private Sewage has reviewed these plans for private sewage system code requirements only. These plans have not been reviewed for the code requirements set forth in Section ILHR 82 for general plumbing or in Chapters 50-64 of the Wisconsin Administrative code. This approval is for the following components only: - NEW MOUND Inquiries concerning this approval may be made by calling (608) 785-9348. Sincerely, 9 8 • ,9 4(G,'. D M. SWIM o~zc~~ Section of Private Sewage Division of Safety and Buildings mn rho r- PPP039/0009n,/55 a ~ ~•.Ja E,~,. cc: Private Sewage Consultant. Tr SBDd6423 M. 01/91) Page of 6 MOUND STEM FOR ~ 4 lJr~ Act A 14 BEDROOM RESIDENCE LOCATED IN THE SW 1/4 OF THE StZ 1/4 OF SECTION Z-~ TZe N, R ~9 W, TOWN OF T"(2l1`j , 5T- C-QAtX COUNTY, WISCONSIN. -~~o~_ ~ = or-__~ SwJ --~~c.u1~D~o--I!~► you_c.--S or cs s ~ t~~~- ?3_ZZ-~ INDEX PAGE l 'of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN PAGE 3 of 6 PLAN VIEW-CROSS SECTION. PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT PAGE 5 of 6 PUMPING CHAMBER PAGE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR N `a~ 31 _ _1.1731 sY _ST._ lv a it~~s w~ sLl bZZ PREPARED BY ®x~~~6@@®@Als~a~,.V WEGE[~E1F~ SO I L TEST I NG AND a®~ •'g DES = G4V SEES V ICE ® ARTHUR L. WEGERER ~ • P9+5 ? w P. 0. BOX 74 421 M. 1SAI11 5T. s ELLS`~SRTH, RIVED. FALLS. VI 54422 715-4L,-41b5 • •••r 4 -SIky31%- s - Z S-C7 3 93 _B$ JOB NO. PLOT PLAN Page Z- of 6 Scale 1"= 30' L.Oc.t'ZCZ01v S~c~TC-1~1 O _ . -c. Z1v E, . Pt ~ 1.,1►~ ~ . 2uw-o l.o T ~ I) ` ,INGE C r , yS 1'rE pf1` ,4 4o c L ~o~ ° q ,cos ° o►vls~o~+ of ~ 97 ` t y° f m WoT co~pr~cr OR Ll~S1vRa~ 1 scr -mks Ut(m 1 TEES ~1 z,°Lo L I ~ lsS tD~CE 1 ~ ~ u a A ~S'Q~. SQlte..E ~8''~1BuvE ' L 6r-6\3p m 1Jv ,o SST y4pbC P 15'b~q. Tpu-t ~C a Y''PVC - 1 r r CAV`N~~. ~6 L _ ZS ` trL. 4s o c a'2 of ~ '`'9th 01.98 9 `RU S r-c~u 4F r ~...oT L11~lE ~lV- 9' B?~ - fit,. f m00:0~ o1J 'WE ftT USkST SO' Pi-tz '1 Mou~v~ ZSL ' O co 3 NOTES: VIM-lb NT LQVT Z S1 P1tu► 1 Tft1u1z S . 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. required) 3. Install 4" observation pipes with approved caps. ( Z required) 4. Septic tank to be \2p0 gallon capacity manufactured by ~~R.4 1AJ T1a:k.S 5. Bench Mark S ~ti3d,1~ pL-kN 6. Divert surface water around mound to prevent ponding at the uphill side. Page 3 Of 6 5t 34044o Approved Synthetic Covering Distribution Pipe Medium Sand H G Topsoil F Elev qq.0 -J E D 3 .'y strtF b % Slope Ily ~C yl Bed Of %2•- 2 %2 Force Mbin Plowed Aggregate From Pump Layer D Ft. ' , 110NS LABOR & Hu~ a pt:P[. OF 1~U5TRY AN ~ ILp=NGS E \.Z Of SAFETY Ft. avIsw ross Section Of A Mound System Using Bed For The Absorption Area F Ft. SEE GO NOENCE G 1• b Ft. A 8 Ft. H 1• S Ft. Linear Loading Rate= 9• S GPD/LN FT B 61 Ft. Design Loading Rate= 0.3 GPD/SQ FT I ZL4 Ft. J a Ft. K 10 Ft. .Ite -e n _L_ L 63 Ft. Fefte4r W 4O_ Ft. L j Observation Pipe $ - K I---------------------- r A - - - W o Force Main 2"- 2. Distribution Bed Of Pipe Aggregate Observation Pipe Permanent Markers (Anchor securely) Plan View Of Mound Using A Bed For The Absorption Area Page L1 Of (o Perforated Pipe Detail 59340440 0 End View )Perforated End Cap. PVC Pipe Install permanent marker at end of each lateral rn Holes Located On Bottom, Are Equally Spaced Q S PVC Force Main Q PVC Manifold Pipe )IStrl ution Pipe Last Hole Should Be I Next To End Cap End Cap P 30 Ft. Distribution Pipe. Layout S Ft. X Y $ Inches SVIM PRIVATE SEWAl3E Y LI 8 Inches COnditim7ally Hole Diameter '1y Inch P ffitft 0 V ,a ar. Ae ii Lateral 11 11~y Inch(es) Manifold Z- Inches . OF IOUSTRWM "'MN RPAPON= Force Main " Z Inches INGS # of holes/pipe 8 R Invert Elevation of Laterals 94-S Ft. ,E q Place 1st hole Z~ from center of manifold with succeeding holes at ~$y intervals. Last hole to be next to the end cap. PUMP CHAMBER CROSS SECTION Ault) SPECIFICATIONS ' PAGE S OF VEIJT CAP S0340440 4* C.I. VENT PIPE WEATHER PROOF APPROVED LOCKING MANHOLE JUAICTIOW SOX 10 'FROM ODOR COVER WITH WARNING LABEL ? . IZ•MILI. WIUOOW OR FRESH ( - AIR INTAKE I GRADE e1. q K. s* i 4 MILL 10' MIN. CONDUIT-- S ,':STEM PROVIDE i ~Il WLET p Y AIRTIGHT SEAL I I i I / APPROVED JOINT A Tank cans„ ~ shall comply I I ( APPROVED JOINTS with approved f w t~ 3.1nd ILHR 83.20 111 pipe extending ALARM 3 feet onto Pt. OF I4S, )USTRY, LABOR & HWI iAI RELATIONS ' I I I I I ID"x solid soil. ! N OF SAF AP Is ILUI NGS I I ow i Both sides of ( i~~z Z- 0 tank. $3.30 I LLEV. FT. WRP" 0E PUMP OFF D 8Z.~0 COUCRETE 5LOCK 3 * APPRWf RISER EXIT PERMITTED OIJLy IF TAWK MANUFACTURER HAS SUCH APPROVAL. REDOING SPECIFICATIONS 005E 1~EJ~1~y ItiJr z.S. TANKS, MAt►IUFACTURER: IJUM6ER OF DOSES: -_-PER OAy TAMK 51ZE : a C~ 0 6ALLOW S DOSE VOLUME S.S . \1.QC~ SYSrL" I S II►ICLUDIN6 bACKFLOW: L` l10' `a GALLONS ALARM MANUFACTURER: MODEL HUMBER: ~~l l'Iw CAPACITIES: A=. _.WCHES OP. GALLONS SWITCH TYPE: - MOLcua-Y B = Z INCHES OR 301' 3WLOLJS PUMP MANUFACTURER: S C=~IWCHES OR 126'5 GALLONS MODEL WUMDER: W l~ V S p: ~Z INCHES OR LIE-' GALLONS SWITCH TYPE: NOTE: PUMP AND ALARM ARE TO OE INSTALLED OW SEPARATE CIRCUITS MINIMUM DISCHA-R6E RATE 3"1' `'L GPM VERTICAL DIFFEILENCE BETWEEN PUMP OFF AUO.OISTRIBUTION PIPE.. 2-0 FEET + MIIJIMUM NETWORK SUPPLY PRESSURTTE//.... . 2.50 FEET + FEET OF FORCE MAIN X Z 33FY00fEFRICTIOU FACTOR. 113 FEET TOTAL OyUAMIC. HEAD FEET DIAMETER ILITERIJAL OIMILWSIOLIf OF TA UK: LEW&TH ;WIDTH ;LIQUID DEPTH .~Z.z._.. BOTTOM AREA Lj S:1'7 231- 19 - .6 V GAL/INCH AS PER MANUFACTURER GAL/INCH "MflcGN 6 ot- 6 .y WHV=5 1/2 HP Residential and Commercial Sewage Pump DIMENSIONS 41 v,6 sK MECHANICAL FLOAT SWITCH Mercury-free, 90' angle operation 5'h O POWER, SWITCH CORDS - Quick-connect, watertight fittings 21/32 11/2 ' ~--+F b G TETHER LENGTH PIMP AND MOTOR SHAFT ON 416 stainless steel 1/2-HP PSC MOTOR T 1750 rpm built-in overload protection 18 UPPER SLEEVE, 2' NPT OFF LOWER BALL BEARINGS t2h Take radial loads, absorb upthrust r 57/8 ROTARY SHAFT SEAL 3:Y4 2' INLET Carbon, ceramic faces 21/32 PERFORMANCE CURVE 1 CAPACITY LITERS PER MINUTE 0 100 200 300 400 500 600 700 14 i 44 13 40 12 36 11 TWO-VANE, tl 32 70 ru SEMI-OPEN EMTELLER b e i g o 28 ` Most efficient pumping 8 0 a W W = 24 _ 7 CAST IRON VOLUTE Z.Zw 'f' ~.7 ~ ~ 6 Passes 2" dia. solids ° o 16 5 12 4 3 8 2 4 1 0 20 40 60 80 100 120 140 .160 180 CAPACITY GALLONS PER IYNUM 3,.~t y F. E. Myers, A Pentair Company 1101 Myers Parkway M"rv Ashland Ohio 44805-1923 K3200 9/91 419/289-1144 Printed in U.SA FAX: 419/289-6658,`TLX: 98-7443 = SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations PRIVATE SEWAGE PLAN APPROVAL Western Regional Office 2226 Rose Street. LaCrosse, Wisconsin 54603 WEGER.ER. SOIL TESTING & DESIGN PO BOX 74 RIVER FALLS WI 54022 RE: Plan Number: S93-40440 Date Approved: June 7, 1993 Gallons Per Day: 600 Date Received: May 26, 1993 Project. Name: LA PER.R.E, JAMES Location: SW;SE;21;28,19W Town of TROY County: ST CROI X The plumbing plans and specifications for this project have been reviewed for compliance with applicable code requirements. This approval is based on Chapter 145, Wisconsin Statute--, and the Wisconsin Administrat.i_ve Code, The plans are stamped 'conditionally approved'. This approval is contingent upon Compliance with any stipulations shown on the plans. All items t.ha.t. are noted must he corrected. All permits required by the city; village, township or county shall be obtained prior to construction. The licensed plumber responsible for this installation shall keep one set. of plans with the department's approval stamp a.t the construction site, The installer shall notify the appropriate inspector when inspections can he made. This approval will expire two years from the date approved or if a. sanitary permit is obtained, it will expire the day the initial sanitary permit expires. The Section of Private Sewage has reviewed these plans for private sewage system code requirements only, These plans have not been reviewed for the cone requirements set forth in Section ILHR 82 for general plumbing or in Chapters 50-64 of the Wisconsin Administrative code, This approval is for the following components only: - NEW MOUND Inquiries concerning this approval may be made by calling (608) 785-9348. Sincerely, % #(G,AD M, SWIM Section of Private Sewage Division of Safety and Buildings PPP039/0009n/55 cc: Private Sewage Consultant. SHn-6423 I R. O V91) Page of 6 MOUND SYSTEM 5 v V A q BEDROOM RESIDENCE LOCATED IN THE Sw 1/4 OF THE Sk~ 1/4 OF SECTION -Ll TZe N, R 19 W, .TOWN OF C TW I X COUNTY, WISCONSIN. _ ~ os 01= c s tZ ~1 -A D__Ii VO:t~- B o~ cS r-J S' p"E Z3 -1z) INDEX PAGE 1'of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN PAGE 3 of 6 PLAN VIEW-CROSS SECTION PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT PAGE 5 of 6 PUMPING CHAMBER PA GE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR i w ca% ~o3L_Sr_ S_T, iZ.IU_ R -:F-A c.LS wi sUOZZ PREPARED BY WEGEEZEFZ SO I L TEST I NG eaTr® AND w, s4 DES = GPI SSREI I CE o° ARTHUR L. D.3!Sy o P.O. BOX 74 421 K. KAIN ST. KLS:hcR7H, w5. 1 RIVE? FkU. KI 54022 ' 715-425-0165e~~~u1N;v ••.r Q IG14 a~ees~ S - Z S-~ 3 I q3 ' B a JOB NO- PLOT PLAN Page Z- of Scale 1"= 30' • • ~.oc.r~oty f S1~~Tct1 O _ DoT E• -~z8. 4.4" (A itiollally 0-10 r y~N s934044o C Woft N SOR R Ntl RS 0 ~l10RSVO, a A ~ to i~ -ft avlsa0 of s 0 9 E'.' m tivoZ• w~"ta~cr J f~ Let~R i 'p TICS Z 1 gal - tS'~~ 5p1k.E ~8''ABUVE GRp`lxlp Irv .o S 9 94, ►5'Din. Tnet wuua YHp~~ ~ z5" i6p.Q~ ~ tTl.afBo ~ ''9th tL 48 9 - - L-oT LIVE -)ly. 9 tyo WALL ?p 8E ft'T X 51` So' F-tom VnouKYv ~T ~oS ~t~ NOTES: ftr CS~~vT Z s' Fiwm T z S 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. required) 3. Install 4" observation pipes with approved caps. ( Z required) 4. Septic tank to be \jp(3 gallon capacity manufactured by L ~?-4 wE)LrEc s 5. Bench Mark s3C1J~ pl,kN _ 6. Divert surface water around mound to prevent ponding at the uphill side. Page 3 Of 6 s934044o Approved Synthetic Covering Distribution Pipe Medium Sand Topsoil F Elev _ 99.0 ~ I 3 E D ,F-1NAGE b ;.,,j% Slope conditionally Bed Of 2 %M Force Mbin Plowed 2 2 Aggregate From Pump Layer l e ~qS D 1.O Ft . of IiiLrMSTRY, LABOR & K PdAN ~ plYlg)p OF SAFETY AN Lou" ross Section Of A Mound System Using F Z-Z Ft. F Ft. Bed For The Absorption Area SEE CO fJf<NC~ G \.u Ft. A 8 Ft. H S Ft. Linear Loading Rate= 9•S GPD/LN FT B 61 Ft. Design Loading Rate= 0.3 GPD/SQ FT I ?L4 Ft. J 6 Ft. K 10 Ft. ~ L 03 Ft. FePee444.n-_ W 40- Ft. L Observation Pipe 8 K III r- A ( - - - I - W i - Force Main ~Distribution Bed Of 2 - 2 2 Pipe Aggregate Observation Pipe Permanent Markers (Anchor securely) Plan View Of Mound Using A Bed For The Absorption Area Page L1 Of (o Perforoted Pipe Detail 0 End View )Perforoled End Cop. PVC Pipe one`` Install permanent-marker -4e.at end of each lateral Holes Located On Bottom, Are Equally Spored S 7 PVC Force Main P PVC Manifold Pipe Distri ution PiQe Last Hole Should Be I Next To End Cap End Cap . P 3O Ft. Distribution Pipe. Layout S --14_ Ft. PRIVATE X _8 Inches BEyyAQE ~T1M Y L18 Inches Conn- ltional1y Hole Diameter '/Y Inch AP Lateral I 'IV Inch(es) PROVED Manifold Z- Inches • Of O MMY, LABOR & HU RLRADON= Force Main " Z Inches OF SRFEfY AND LOW(,g # of holes/pipe 8 BEE A Invert Elevation of laterals 44.S Ft. NOENCE It Place lst hole Z4 from center of manifold with succeeding holes y at )4$ intervals. Last hole to be next to the end cap. PUMP CHAMBER CRO55 SECTION AND SPECIFICATIONS ' PAGE S OF C~ VENT CAP :34 04 0 4'c.I. VENT PIPC WEATHER PROOF APPROVED LOCKING MANHOLE 10 FROM JUNCTIOU BOX COVER WITH WARNING LABEL ~ oooR, WINOOW OR FRESH Irma). I - AIR INTAKE I GRADE I k'1.4 Y. S ~ i 40 MIN. 10' MIIJ. COWDUIT-- SYSTEM PROVIDE I IMLET AIRTIGHT SEAL I I i I dank-,,,c _n APPROVED JOItJT A tan shall comply i I APPROVED JOINTS } ~ahH nd ILHR 83.20 with approved ALARM pipe extending ' I 1I 3 feet onto OF INDUSTRY, LABOR & HUM" RHATIONS ( I solid s o i l . I N OF SAF AND IUtiNGS I I Oki Both sides of tank. 83.30 I L. L E V. F T. C~RAFif~N CE PUMP __j ~ OFF D 87-A O COLICRETE BLOCK 3' ApPRavCr RISER EXIT PERMITTED OWLI IF TAWK MANUFACTURIR HAS SUCH APPROVAL. gEpplµ~ SPECIFICATIOMS DOSE L/ NUMBER OF DOSES: PER DAU TANK MAIJUFACTUR w CR. TANK .+lZE. aCl~ 0 GALLOWS DOSE VOLUME ALARM MANUFACTURER: S'S' SFUQS~M SY,3rL-a1 S INCLUDING, DACKFLOW: ti~bL: GALLONS MODCL NUMBER. l01 ~~w CAPACITIES: A= 11 -IWCHE5 OR L Z' GALLOWS SWITCH TUPIC: a2C1_u V_Y B = Z INCHES OR 3&( LLOL15 PUMP MANUFACTURER: ~e-i t2.5 G-_y~IWCHES OR l76'a GALLONS MODEL NUMBER: W to V S D- 11 INCHES OR 2-2-1-2 GALLONS SWITCH TYPE' Y-1 ~ZC~C1 { MOTE: PUMP AND ALARM ARE TO OE MIMIMUM DISCHARGE RATE :S"- GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE DETWEEW PUMP OFF AUD.DISTRIBUTIOW PIPE.. %6-10 FEET + MIKIIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . 2.50 FEET ♦ 1 6~ FEET OF FORCE MAIN X ~'33f~or>FRIt7lorl FACTOR. 1_3 FEET TOTAL 09UAMIL HEAD FLET DIAMETER 7 6 i/. INTERAIAL DIMLWSIOIUi OF TANK: LENGTH _ ;WIDTH ;LIQUID DEPTH BOTTOM AREA Lf S3`1 - 231= l q . b~ GAL/INCH AS PER MANUFACTURER = GAL/INCH _ • I~~GN ~ ot= 6 r WHV5 1/2 HP Residential and Commercial Sewage Pump DIMENSIONS + NA MECHANICAL FLOAT SWITCH Mercury-free, 90' angle operation 51/4 O POWER, SWITCH CORDS - + Quick-connect, watertight fittings 21/32 1 '12 5 b 6' TETHER LENGTH PUMP AND MOTOR SHAFT ON 416 stainless steel 1/2-HP PSC MOTOR r 1750 rpm built-in overload protection 18 UPPER SLEEVE. 2' NPT OFF LOWER BALL BEARINGS 12% Take radial loads. absorb upthrust r 57/e ROTARY SHAFT SEAL 3% = 2' WLET Carbon, ceramic faces 21/32 1 PERFORMANCE CURVE CAPACITY LITERS PER MUTE o 100 20o 300 400 500 600 700 1 1a ~ 44 13 12 36 11 01 TWO-VANE 32 70 SEMI-OPEN IMPELLER = 9 z Most efficient pumping 10 6 0 J 24 7 = J CAST IRON VOLUTE Z'Z' 2D - Passes 2' dia. solids 6 0 16 5 12 4 3 6 2 1 1 0 20 40 60 60 100 120 110.160 160 CAPACITY GALLONS PER VAWM 3i-qy F. E. Ashland, A Pentair Company 1101 M"M Myers Parkway Ashland, nd, Ohio 44805-1923 K3200 9/91 419/289-1144 O.:nlnA in IICA - [:AV-A10/non CCCO -TV.no 7A A7 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER_ Z cA,M 2.S ✓ Lc~ ~LI~{-~.~' P t qSS/~ h ~q' ADDRESS: FIRE NO: fi y LOCATION: s(~ 1/4, ~_1/4, SEC.f T,N-R W, TOWN OF: ST.•CROIX COUNTY X SUBDIVISION: r~ wYi V C)rx k.S LOT NO. ` Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system: St. Croix County residents may be eligible to receive a grant to help with the cost of the replacement of a failing system, which was in operation prior to July 1, 1978. St Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to the St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman. plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating 'condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. Certification from will be sent approximately 30 days prior to three year expiration. I/WE, the undersigned have read the above requirements and agree to maintain the private sewage disposal system-in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification form must be completed and returned to the St. Croix county Zoning Officer within 30 days of the three year expiration date. SIGNED:- DATE: J -7 3 i St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 STC-loo This application form is to be completed in full and signed b the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Shoulthis development be intended for resale by owner/contractor,(spec liouse), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of property ~I. Pr-yp Location of property 5&A-/4 7t--1/4, section 'ZI , T N-R W .Township 0 Mailing address A) 5'7' Address of site L~~ CD~tlV~ 'C 1D 14 1 _ ~iq Cc ( I 1 Subdivision name C61i"h C)p"k ; Lot no other homes on property? ___.yes, ~ No Previous owner of property WZC-Al M 14 Y ,UdRw" grcZcZJ'ZM Total size of parcel Date parcel was created J-)~_ k1 C> l~ Are all corners and lot lines identifiable?_ Yes No Is this property being developed for (spec house)? Yes No 7to Volume1nd Page Number of Deeds . as recorded. with the Register 114CLUDE WITH THIS APPLICATION THE FOLLOWING: - A WARIUVITY DEED which includes a DOCUMENT NUHBER, VOLUME AND PAGE NUMBER & THE SEAL Or THE XIEGISTGR OF DEEDS. In addition, a certified survey, if available; ;would be helpful so as to avoid delays of the reviewing process. If the deed description references to a certified Survey map, the certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I(wc) certify that all statements on this form are true to the best of ny (our) knowledge that I we am (are) the owner() f the property described in this information form, by virtue sofoa warranty deed recorded tt~e office of the County Register of Deeds as Document Teo. own the proposed site for the sewage di p salt system) orr I e(we) obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorde,~ No. ,the office of county Register of deeds as Document ignature of aplicant Co-applicant Date of Signa ure Date of signature I~ .I , II DOCUMENT NO. WARRANTY DEED I --HIS SPACE RESERVED FOR RECORDING DATA " STATE BAR OF WISCONSIN FORM 2 -1982 - VOL 9J rP" r. 47 REGISTER'S OFFICE Country Oaks- a Wisconsin Partnership by Laurence W. ST.CROIX CO., WI - - Murphy and Norwood- A Ecklund . Reed for Record JUN 181992 conveys and warrants to James _ D.-- LaPerre_"and- Ann. . Marie.._LaPerre, Gt -..husband.-and. wife. .as..survivorship_-marital-.property 8'40 A. M Regater of Deeds RETURN TO . . the following described real estate in S _*--Croix ____County, - State of Wisconsin: Tax Parcel No:.............................. Part of SE 1/4 of Section 21-28-19 described as follows: Lot 4 of Certified Survey Map filed January 9, 1991 in Vol. "8", page 2312. TOGETHER WITH a 66 foot private roadway as shown on said Certified Survey Map. Gt.C'~ This - - - --is not- homestead property. - (*A (is not) Exception to warranties : easements, restrictions and rights of way of record, if any. Dated this day of - June 19..92 County Oaks: -7.-(SEAL) ----------(SEAL) ur nce W. Murphy - ---------------------------(SEAL) )3_y A L) orwood A. Ecklund - AUTHENTICATION ACKNOWLEDGMENT Signature (s) STATE OF WISCONSIN ss. J 5(. -.-•"-County. authenticated this --.-----day of 19 Personally came before me this ._._....ay of June , 1992_.. the above named s -----Laurence W. Murphy TITLE: MEMBER STATE BAR OF WISCONSIN Norwood A. Ecklund (If not , _ _ _ _ authorized by § 706.06, Wis. Stats.) to me known to e`~t,M #1Asi... who executed the b. 4t foregoing ins e a~a4*41tc~ Sdge a amp. THIS INSTRUMENT WAS DRAFTED BY at Law Jose h D Boles Attorne........................... River Falls, WI 54022 Notary Public :a, County, Wis. (Signatures may be authenticated or acknowledged. Both My Commissioi$~iJer not state expiration are not necessary.) date: f_~ . u~~ wls-- ---,?_5~., "lif eN4461144 ' •Natnm of persons signing in any capacity should be typed or printed below their signatures. WARRANTY DEED STATE BAR OF WISCONSIN Wisconsin Legal Blank Co., Inc. FORM No. 2 - 1982 _ Milwaukee, Wisconsin Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 taborend Human Relations ! Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code . COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must i e, but S~ C-1~ U I X not limited to vertical and horizontal reference point (BM), direction and % of slop , Cale or ARCEL .D. # - t 0 g4" d~ Su dimensioned, north arrow, and location and distance to nearest road. 2 q APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATI ) R _ DATE d PROPERTY OWNER: 11.0 PROPERTY LOCA 10 1/4 S E 1/4, S 21 T Z-a , N,R 19 E (or OW- PROPERTY 'Z ~►►-j F 5 Lpt p mtE OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # N8531 1031 5T SI• 0,S" VoL$,~9 Z3\-L CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE MOWN NEAREST ROAD \-'1IUE •-tgl..l.SrW1 Sq(S2.t (7)IS) ai.s. C►ISb 7- R`{ I_TQWL3S\j% t Ro . New Construction Use ~Q Residential / Number of bedrooms y ) Addition to existi building j j Replacement [ ] Public or commercial describe Code derived daily flow bow gpd Recommended design loading rate a • 3 bed, gpd/ft2 o • 3 trench, ft2 Absorption area required Soo bed, ft2 S p c trench, ft2 Maximum design loading rate 0--S bed, gpd/ft2 O. 6 trench, gpd/ft2 Recommended infiltration surface elevation(s) 9q. 0 ft (as referred to site plan benchmark) Additional design / site considerations t'tov ),+Q w / 'a'>< (-3 ' 8NU - >-71,v . ) ' o r s r~wv I- t-L Parent material \_z,, S s o v C- Tt ~_L Flood plain elevation, if applicable N). ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable for s stem ❑ S ER U [as ❑ U ❑ S ®U ❑ S ®U ❑ S ~U ❑ S FIffU SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tmrtch o-to ~o1-Lv- 3/3 - sal Z'~ sbk wt~>^ q,5 O.` 2ui o. S o. L 1 `1\Z 3) - S 1 I Z F S bk YIn `f h 10 t3 Z. Ground 3 32_SOS`')tZ VJ%( s elev. q~, b ft. 3 (S ka-IQ Lc Pj SS `UtZ wIT" rv #OeL.y PAr0_k M V T Ia/F L C? L w\`~•tI 1VtR (4ty SOOpu Qnk'rS S►~ ~Z,1t'1~"D Ar L12', Depth to limiting factor 3 z Remarks: Boring# O-vZ 1c)-m, 313 S)) Z~Sb~T_'F►~ cS 3o`S a. S o•~ Z ~ Z ~z-21 10 ~t IZ 31 b - s ~ ~ Z ~ s ~k t.r'f I` c s 2 oS o. 6 3 z-)-33 ~.S1-1 2 yly t~,.sti~sl~ cSblz Ground elev. Lq 33 _L47 -I_ 5 Y R y!y S I WN L- - - _ Ct~ ft. Depth to C-Oh' " S ' z ' r t Q F M h S S J S c l GTU'*jP ,b t S " 3 limiting factor Remarks: CSTName:-PleasePrint Arthur L. We erer Phone: 715-425-0165 Address: Soil Testing & Design Service-P.O. Box 74 River Falls,WI 54022 Signature: Date: CST Number: ~/3_c~ES ~r'Nl x,179 3 M00576 PROPERTY OWNER L ~L'1Z~2 C SOIL DESCRIPTION REPORT Page ofd PARCEL I.D.# DL{O - 1085/- ~u- L S o Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench v4:»`l D- l? 1 by ~Z 3 3 s i t J b vi `F1~ cS 3 i o, S o, L H W 316 - S Z , bk wr ` cs z o. S o . L Ground 3 13-39 $ y 3L - s 1 s 1k `f c S o~\4 S elev. •I ft. y 39-49 -7-S sYR 5/8 S ~ ~ w~ w► T1- Depth to S Ll 3 limiting fag" I Remarks: Boring # rf•6 Ground L~~U elev. ft. 10i I AY 2 1 9993 Depth to J.,v limiting w factor A~Xv Remar Boring # ~n Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft Depth to limiting factor Remarks: SBD-8330(8.05/92) s PLOT PLAN Page 3 of 3 SCALE 1"= 30 ' L.o~r`ZC~I~I~i v >y\; P►Zrvn -;z t19" W. 916 -r y~ S ~o tvoT cu~arcr ry oR ~tSl'URt~ 1-! j~~ `Tr11 S Pt'~~'q Sim t M I V o TTI- Fs Z Lo cF I ~ S p llt.~ ~8'R Bu~E Geuv,~U tn, I s kFT Sl I fur covlou~. L _ ZS_ ~t,gso c 5.7 Z ~L989 14. 9 9 No}~: ,-J cLL -M 8re ft`T uz ST Sp f-110m m UP nP B}J' - P-L. 100.0 , Oka \'S kjt~ VN r ~r It ST S ' 'Fit u 'M iw\- S Z P LOT Cowie t. 93 q3 0 576 (715 ~ 423-0165 M00576 CST Signature Date Signed Telephone No. CST # Parcel 040-1083-80-000 04/19/2005 11:50 AM PAGE 1 OF 1 Alt. Parcel 21.28.19.328C 040 - TOWN OF TROY Current X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner * DUCLOS, GARY A & MARLENE C GARY A & MARLENE C DUCLOS 237 TOWNSVALLEY RD RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 1.500 Plat: N/A-NOT AVAILABLE SEC 21 T28N R1 9W PT NE SW THAT PART OF Block/Condo Bldg: NE SW KNOW AS PART OF LOT 4 OF CSM V 4/1157 INCLUDES P332C, P333A, P334A & Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) P335 21-28N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1213/131 WD 07/23/1997 766/151 2004 SUMMARY Bill Fair Market Value: Assessed with: 26789 Use Value Assessment Valuations: Last Changed: 07/20/2004 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 30.320 4,700 0 4,700 NO Totals for 2004: General Property 30.320 4,700 0 4,700 Woodland 0.000 0 0 Totals for 2003: General Property 30.320 5,000 0 5,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 040-1084-40-000 04/19/2005 11:49 AM PAGE 1 OF 1 Alt. Parcel 21.28.19.332C 040 - TOWN OF TROY Current [XI ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner DUCLOS, GARY A & MARLENE C GARY A & MARLENE C DUCLOS 237 TOWNSVALLEY RD RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 0.000 Plat: N/A-NOT AVAILABLE SEC 21 T28N R1 9W PT NE SE THAT PART OF Block/Condo Bldg: NE SE ALSO KNOWN AS PART OF LOT 4 OF CSM V 4/1157 ASSESS WITH P328C Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 21-28N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1213/131 WD 07/23/1997 766/151 2004 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: Description Class Acres Land Improve Total State Reason Totals for 2004: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2003: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00